Provider Demographics
NPI:1083723688
Name:DARDES, NICHOLAS P (DO)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:P
Last Name:DARDES
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:955 RIBAUT RD
Mailing Address - Street 2:BMAC CREDENTIALING
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-5441
Mailing Address - Country:US
Mailing Address - Phone:843-522-5674
Mailing Address - Fax:843-522-5678
Practice Address - Street 1:BEAUFORT MEMORIAL LOWCOUNTRY MEDICAL GROUP
Practice Address - Street 2:300 MIDTOWN DRIVE
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29906-5200
Practice Address - Country:US
Practice Address - Phone:843-770-0404
Practice Address - Fax:844-296-2308
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2019-07-24
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Provider Licenses
StateLicense IDTaxonomies
SC365207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC003659Medicaid
SCE23176Medicare UPIN
SCE231765818Medicare ID - Type Unspecified